AHA issues consensus statement on improved survival after in-hospital cardiac arrest
In a recent consensus statement, the American Heart Association defined in-hospital cardiac arrest as occurring whether the patient has been admitted or not, and “for which resuscitation is attempted with chest compressions, defibrillation, or both.”
Institutional leaders and health care providers are encouraged to routinely establish and report patient self-determination of care documentation, according to the statement. This should include explicit “do not attempt resuscitation” status. Hospital staff should recognize the symptoms of cardiac arrest and be familiar with resuscitation techniques, including chest compressions and use of an automated external defibrillator. Institutions also should conduct ongoing quality assurance of in-hospital cardiac arrest procedures that includes tracking and reporting incidence of these events and documenting outcomes at discharge. Standardized, evidence-based approaches to end-of-life therapy should be implemented. This should include steps for organ donation and tissue recovery.
Regulatory bodies should mandate reporting of in-hospital cardiac arrest incidence and outcomes, do not attempt resuscitation status rates per 1,000 admissions and modification of ICD coding for optimal data collection.
The authors of the statement encouraged research funding agencies to prioritize all aspects of in-hospital cardiac arrest care to broaden the knowledge base about these events.
National and international bodies that may create guidelines for resuscitation should develop separate recommendations for in-hospital and out-of-hospital cardiac arrests.
The guidelines were published, in part, due to wide variation in reported incidence rates of in-hospital cardiac arrest incidence rates. Recent figures from the AHA indicated that only 24.2% of patients who experience this event survive to discharge.
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